Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Arterial hypotension and prerenal failure in an extremely preterm infant associated with oral sildenafil

Subjects

Abstract

We report significant hypotension and prerenal failure in an extremely preterm infant following two doses of oral sildenafil that warranted discontinuation of the drug and treatment with inotropes. Blood pressure and urine output normalized after 24 h of withdrawal of the oral drug. Sildenafil should be used cautiously in extremely preterm infants early in the neonatal course, where there is limited data on its efficacy and safety.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Shah PS, Ohlsson A . Sildenafil for pulmonary hypertension in neonates. Cochrane Database Syst Rev 2011; 10: CD005494.

    Google Scholar 

  2. Cavallaro G, Agazzani E, Andaloro L, Bottura C, Cristofori G, Mussini P et al. [Sildenafil and nitric oxide inhalation in neonatal pulmonary hypertension. Three case reports]. Pediatr Med Chir 2008; 30: 149–155.

    CAS  PubMed  Google Scholar 

  3. Namachivayam P, Theilen U, Butt WW, Cooper SM, Penny DJ, Shekerdemian LS . Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children. Am J Respir Crit Care Med 2006; 174: 1042–1047.

    Article  CAS  Google Scholar 

  4. Konig K, Barfield CP, Guy KJ, Drew SM, Andersen CC . The effect of sildenafil on evolving bronchopulmonary dysplasia in extremely preterm infants: a randomised controlled pilot study. J Matern Fetal Neonatal Med 2014; 27: 439–444.

    Article  Google Scholar 

  5. Barst RJ, Beghetti M, Pulido T, Layton G, Konourina I, Zhang M et al. STARTS-2: long-term survival with oral sildenafil monotherapy in treatment-naive pediatric pulmonary arterial hypertension. Circulation 2014; 129: 1914–1923.

    Article  CAS  Google Scholar 

  6. Mukherjee A, Dombi T, Wittke B, Lalonde R . Population pharmacokinetics of sildenafil in term neonates: evidence of rapid maturation of metabolic clearance in the early postnatal period. Clin Pharmacol Ther 2009; 85: 56–63.

    Article  CAS  Google Scholar 

  7. Ahsman MJ, Witjes BC, Wildschut ED, Sluiter I, Vulto AG, Tibboel D et al. Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube. Arch Dis Child Fetal Neonatal Ed 2010; 95: F109–F114.

    Article  Google Scholar 

  8. Wardle AJ, Wardle R, Luyt K, Tulloh R . The utility of sildenafil in pulmonary hypertension: a focus on bronchopulmonary dysplasia. Arch Dis Child 2013; 98: 613–617.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H Balasubramanian.

Ethics declarations

Competing interests

The authors declare no conflict of interest

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balasubramanian, H., Strunk, T. & Kohan, R. Arterial hypotension and prerenal failure in an extremely preterm infant associated with oral sildenafil. J Perinatol 35, 458–459 (2015). https://doi.org/10.1038/jp.2015.31

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2015.31

This article is cited by

Search

Quick links